Q: How pervasive is the concern that treatment with psychiatric medications will lead to weight gain?
A: It’s a very common concern. The two most common questions that patients ask me are, “Will I become dependent on the medications?” and “Will I gain weight?”Q: Do most psychiatric medications cause weight gain in patients starting a medication regimen?
A: Most of the antipsychotic medications could cause some weight gain–some more than others. Some antidepressants are also likely to cause weight gain.Q: In your experience, how much weight do patients often gain?
A: This can vary considerably. After starting therapy people gain two to six pounds over the course of a year. On the other hand, I’ve had some patients who gained 10, 25, and even 50 pounds. Nevertheless, I’ve had all kinds of surprises. Some patients who are started on a medicine that’s known to cause weight gain don’t gain any weight at all. Everyone’s metabolism is different, and what happens to one patient may be completely different than the outcome for another person–even a family member–who is taking the same dosage of the drug.Q: Why do so many patients gain weight after starting a psychiatric medication?

A: In addition to altering brain chemicals that control mood, psychiatric medicines also alter chemicals that affect appetite, metabolism, and fat storage. It’s thought that the drugs have an effect on histamine receptors, which causes some people to gain weight.
However, medication effects are only party of the reason for weight gain. You also have to consider lifestyle issues. Being overweight and obesity are epidemic in the general population, with two out of three adults now being affected by weight issues. People with severe mental health problems may have even higher rates of being overweight and obesity. When you look closely at their medical histories, you often find that they had gained a substantial amount of weight even before beginning treatment. I treat some patients who don’t know what it is like to drink water, choosing instead to drink soda all the time. I have some patients who drink as much as four liters of soda a day. These carbonated high-fructose drinks area major contributor to being overweight and obesity.
In addition, some patients may have a genetic predisposition to gain weight. A study published in the journal “Science” reported the discovery of an obesity gene that affects the synthesis of fatty acids and cholesterol and is found in about 10 percent of the population.
I believe that the issue of weight gain really has to be viewed in a broader context. Yes, there are medication effects, but there are also the effects of the disease itself, lifestyle, and genetics that must be factored in.

I’m glad you’ve taken up this topic. Weight issues are huge with many of us, myself included. Obesity and depression can be its own downward spiral for someone like me who has a hereditary propensity for putting on the pounds anyway. My non-depressed siblings’ extra 20 or 30 lbs. has become my own extra 150 lbs. Extra weight can lead to depression can lead to bad eating and exercise habits and more extra weight, which leads to lower self-esteem and more depression …. And down we go.
Wellbutrin has been a good drug for me in the weight management area. For me, it has a mild appetite suppressant effect and it adequately controls my depression symptoms.
Weight loss surgery is something to consider if you’re morbidly or supermorbidly obese and/or have co-morbidities like Type 2 Diabetes. Insurance often covers these procedures if there’s a significant enough medical justification. I got an adjustable gastric band (Lap-Band) almost 4 weeks ago, and it’s my hope that weight loss with the band will help me all around, including the depression. I know that my blood sugar has normalized already without any more diabetes meds, which is enough to make me Snoopy Dance.

Chinamom

I’m glad you’ve taken up this topic. Weight issues are huge with many of us, myself included. Obesity and depression can be its own downward spiral for someone like me who has a hereditary propensity for putting on the pounds anyway. My non-depressed siblings’ extra 20 or 30 lbs. has become my own extra 150 lbs. Extra weight can lead to depression can lead to bad eating and exercise habits and more extra weight, which leads to lower self-esteem and more depression …. And down we go.
Wellbutrin has been a good drug for me in the weight management area. For me, it has a mild appetite suppressant effect and it adequately controls my depression symptoms.
Weight loss surgery is something to consider if you’re morbidly or supermorbidly obese and/or have co-morbidities like Type 2 Diabetes. Insurance often covers these procedures if there’s a significant enough medical justification. I got an adjustable gastric band (Lap-Band) almost 4 weeks ago, and it’s my hope that weight loss with the band will help me all around, including the depression. I know that my blood sugar has normalized already without any more diabetes meds, which is enough to make me Snoopy Dance.

Larry Parker

We were just talking about the Depakote (or Zyprexa, or Risperdal, or …) munchies in my support group tonight.
It’s very real. With some of these medications you literally feel like you are never full. It takes extraordinary discipline not to gain weight on such medicines — and when you’re struggling, period, I don’t think you should be blamed for not eating like an anorexic and pumping iron like the Gobernator back in the day.
If I could shed the 50 pounds I gained on Depakote and Zyprexa combined (in two different periods totaling just 9 months), I would literally and figuratively be in very good shape. (Well, I’ve lost 15 pounds so far this year, at least — progress, not perfection.)

Margaret Balyeat

In my case, I think the weight problem is (to a degree) a side effect of the depression rather than the other way around.When I’m in the abyss,ot even just starting down its slippery slope on my mental health tonoggan, chocolate and other comfort foods call out to me. This has been true since my teenage years; in fact one of my younger sisters believe that my eating habits and the resultant weight issues have been a slow form of suicide in my case. (Death by chocolate….hmmm… could ther BE a better way to go?) I’ve had to male some changes since I had my stroke, since diabetes II was discovered at that time and is believed to have been a majot contributing factor to my CVA. Frankly, that’s been easier than quitting smoking, another self-destructive habit I’ve had since the age of twenty-one. One thing I’ve found to be esprcially important, if any medical people are reading this:It’s paramount to be completely honest with your patients without either downplaying or exaggerating the effects their life style choices have had/will have on their lives. when I was in the inpatient rehab unit of our local hospital (and for the most part, those guys were GREAT!) ONE OF THE NURSES TOLD ME THAT IF i EVER SMOKED ANOTHER CIGARETTE, IT WOULD KILL Me! (Not a smart thing to tell a depressive who gains pleasure from tobacco use! Once I was back on my ownhome, I lit up and sat in fromt of my computer screen fully expectingand ready to meet my maker. It didn’t(obviously) happen, so my poor, psyche which already was feeling put upon by all that I had to overcome interpreted that as permission to reindulge that taste. I’m not sure how much of that renewed addiction is physical and how much psychological, nor am I aware of it being a conscious attempt to end my life, but whatever the causes and effects are, it has been next to impossible for me to get into a quitting frame of mind. My blood sugar, cholesterol and hypertension are all under control, and I still do the psych med thing along with journaling, prayer and therapy, but I’m once again a smoker! None of the strategies or commercial remedies I’ve tried (and I’ve tried just about everything excpt acupuncture ) have helped. I don’t know if I would have started again had I not thought it might just pit an end to my misery, I just know that it was a conscious decision to light up again in spite(because?) of the words of that medical professional.

SuzanneWA

I weighed a combined total of 115 pounds (I’m 5’9″) for two years on Depakote and Zyprexa. Then I started doing twice-weekly mystery shops at a hamburger joint, eating 7 Hershey Dark Chocolate Kisses at night, a cup of yogurt and chips&dip at night – and, before I knew it, had gained 27 pounds!! Now – tell me whether it is a lifestyle choice or the meds!! I feel I have to lose between 5-10 pounds BEFORE the holidays start, or I will feel like a blimp. I’ve always been slim, skinny even, but have weighed as much as 175 when I was married. My metabolism runs fast, but lately on the meds, I haven’t been able to lose but 2 pounds since my abrupt weight gain.
Like Margaret, I smoke like a chimney, because I enjoy it. I feel I’ve been blessed on “borrowed time” because I’ve cheated death a number of times since I was 11 years old. I KNOW it’s bad for me; I’ve tried quitting, to no avail. I would react the same way as Margaret if someone was that rude!
So – is it “nurture or nature” with the psychotropic meds? I don’t know, but I DON’T want to be overweight and have a sloppy tummy for my boyfriend – how about you??!!

Margaret Balyeat

Suzzane: Interestingly enough, that nurse was also a smoker! I could smell it when she came into my room one evening after her supper break and commented on how good it smelled which is how the subject came up.
At 5’61/2”, one fifteen sounds like perfection to me! I’m not going to state my weight here for the hole world to see. Suffice it to say that MY “butt prints in the sand” could double as little tidal pools! I did find out at my last three-month up check up last month that I had lost twenty pounds since my last visit (BIG SMILE) My caregiver/guardian angel/friend was shocked because my eating habits haven’t been that great, and die to my hemiparalysis, exercising (even walking) is a big challenge since my insurance company cancelled my physical therapy saying that I had “improved as much as I was going to O”plateaued) One of the hardest things about the recovery period for me s that my various physical.occuparional/speech therapists (NOt, fortunately, my “head therapist have always interpreted my faith in God as the one with the final say on that matter as an “inwillingness to accept/adapt to my new deficiencies/”reality”, a common reaction of stroke survivors, and have chastised me repeatedly for not accepting their insights on my prognosis as the final word. Oh, I DO know that i’m not going to wake up some morning to discover that my left arm and hand are suddenly working again overnight, but I know it was the physical therapy that helped me regain some use of my left leg, and it seemed to me that cutting off that therapy was being defeatist, no matter WHAT clinical research says about the chances of continued improvement past a certain point into recovery! If and when God is ready, i’ll regain the use of my left arm and hand, was my attitude, and certainly being denied contined therapy wouldn’t HURT anything but the ins. company’s bank account! I’ve been a faitly sedentary person most of my adult life (during non-work hours; you can’t truly teach from an always-seated position) and without the therapists planning and overseeing my biweekly sessions and being beside me to push me onward, I haven’t been able to motivate myself to do much on my own. (The lack of availability of the machines also hampers that, and speed walking with only one working leg is a laughable proposition, woth or without my cane! Gyms such as curves or other commercial enterprises (including our local “Y” are reluctant to take on individuals such as myself for–what ELSE?–insurance reasons–so that’s not a viable alternative either. (“Whining” enough for you. T?)
actually, it did my(spiritual, not physical heart good to discover that all my years of antidepressants might have contributed to my weight problem (De Nile”, anybody?)since of all of us siblings (I have three sisters, all of whom also struggle with weight isues I am the one with the most extra weight. I’m also the only one with mental health issues–how fair is THAT? I’ll accept responsibility for my eating habits, but the exercise component and the medication side effects are out of my domain at the present time, since the depression is(IMHO) a more mahor issue in my life and I need all the tools in my toolbox to keep the kennel door locked with the the dog inside where she can’t as easily snatch me up and shake me like a chew toy.!

Blanche

As someone who has been in inpatient rehab several times, during my 2nd time in the facility decided that the hospital and grounds would be smoke free. No more smoke breaks outside twice a day. They provided the patch and nicorette gum, but I observed that most people in rehab smoke, especially people in the hospital for alcholism and drug addiction.
I also observed that most of these people were obsessing about not being able to smoke, rather that focusing on recovery, and so what good did detox and group therapy do?
The outpatient facility was finally allowed to smoke again, behind the fence out of the public view, after a poll taken by the facility showed that 80-90% of their patients smoked. The facility directors relented after the survey, and let the patients smoke between group therapy sessions, to allow patients focus on recovery, rather than waiting for the day to be over so they can smoke.
It is still a sad situation for the inpatients, who use a legal product.

sadie

weight gain is a a serious issue and should not be taken lightly. I’ve gained almost 100 pounds since being on meds and i’ve started to work out i’ve been working out for two months all its done is maintain my weight but i havent lost one singular pound. something needs to be done to change the make of psych meds so you dont have to sacrifice your looks for happyness cause its hard to be happy and ugly

Jamie

For me, the antidepressant Pamelor was given for me to take to help in dealing with pain associated with Neurofibromatosis Type 1. I only take it at night as prescribed by my doctor right before going to bed. I have noticed so weight gain. I’ve never been much of a big eater, but I am still unsure if the weight gain is from the Pamelor or one of the many other medications that I have been given to take at bedtime to help deal with the pain from NF.

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I gained 40 pounds on Seroquel. That’s the bad news. The good news is that I’ve already lost almost 13 pounds of that weight by eating a sensibly low-carb diet and walking & weight training. The weight comes off slowly because of the meds, but it does come off. It takes a lot of personal resources to keep going. I have recently started a blog about this very subject. Check it out!

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